PEDIATRIC RESOURCE GROUP HAS EXPERIENCE AND EXPERTISE IN THE FOLLOWING AREAS
Pediatric Clinical Documentation Improvement (CDI) Programs
PRG has years of experience in starting and leading successful pediatric CDI programs at children’s hospitals and pediatric units around the country. Accurate documentation of the patient’s care is important for the sharing of information amongst the clinical team to provide the best care possible. In addition, complete documentation also ensures that the appropriate acuity of the patient is reflected in the chart, which drives the severity-adjustment for quality and operational metrics and can also significantly impact hospital reimbursement.
Physician Advisor Programs
A physician advisor is an administrative role that has been growing in popularity over the years, especially in pediatric organizations. The physician leader acting in this role works with care coordinators/UM nurses and the care team to triage patients to the appropriate level of care, manages length of stay, facilitates patient flow, educates providers on documentation issues, and acts as a liaison between their physician peers, hospital administration, and payers. The consulting associates at PRG have been at the forefront of the pediatric physician advisor movement and can help your organization design and implement a program that best serves your strategic priorities.
Utilization Management
It’s important for hospitals to have an effective utilization management (UM) program that evaluates the medical necessity of admissions, ensures the patient is placed in the appropriate administrative status (inpatient, outpatient, observation services), monitors the efficiency of the use of health care services and interfaces with payers throughout the stay. Our physician UM leaders can work with your UM team on systems (i.e. InterQual or Milliman) and processes that can create a streamlined and effective UM program.
Patient Flow - Throughput
Moving patients forward in their plan of care in an efficient manner without delays is beneficial to patients, families, and the hospital. To tackle this chronic issue that exists at almost every hospital, we’ll partner with our data scientists to analyze your severity-adjusted length-of-stay (LOS) data, compare it to pediatric specific expected LOS benchmarks, identify where the opportunities for improvement may be, process map suspected inefficient services in your hospital, and then use all of that information to implement interventions that can work within your hospital’s priorities, processes, and culture.
Inpatient Access
The safe and efficient intake and placement of admission requests is a critical function for all hospitals. We can implement or redesign your inpatient access center to minimize missed admissions due to inefficient processes, improve the timeliness of transferring patients to your organization, enhance communication to and from referring providers, and create tracking systems to ensure the improvements are sustained.